Project Snapshot – SONIC study

Study of Neck Injury Imaging in Children (SONIC): Improving the Diagnosis of Spinal Cord, Bone and Ligament Injuries

Many children sustain head and neck trauma during their lifetime. Significant neck injuries – to spinal cord, neck bones and connecting ligaments – can be identified by performing neck imaging with x-rays, or, if needed, computed tomography or magnetic resonance imaging. Yet, it is unclear which children should receive neck imaging in the emergency department (ED), especially in the context of increasing concerns about radiation-induced cancer in children and the discomfort and delays of immobilisation prior to imaging.

This study aims to:

  • investigate the accuracy of existing neck injury clinical decision rules (CDRs) to detect neck injuries in children (external validation) of adult focussed CDRs and the newly developed paediatric PECARN CDR;
  • derive and validate a new CDR for neck imaging in children (the SONIC CDR);
  • assess the cost implications of different CDRs in children;
  • investigate the epidemiology of cervical spine injuries in ANZ.
Study design:

Multicentre, prospective observational study.

Timeframe:

2020 – 2025

Sites:  See link to SONIC project page.
Sample:

PREDICT ~30,000 (depending on prevalence of injuries), children aged <16 yrs with sustained or suspected blunt trauma with at least one of the following: Initiation of spinal precautions pre ED arrival, neck pain and/or considered at risk of CSI by any assessing clinician.

News:

Recruitment has commenced at all sites with over 7000 patients enrolled to date.

We have recruited approximately 100 patients to date with eligible cervical spine injuries (2/3 of the required number).  These eligible patients for accuracy analysis are currently being reviewed by the study spinal surgeons.

Sites are doing an amazing job at recruitment and keeping our missed eligible patient rate at a minimum.

We project that study recruitment will need to continue throughout 2024 and potentially to early 2025 at some sites to ensure we reach the required number of positive injuries. 

 

Project Snapshot -Triage tools for detecting cervical spine injury

Cochrane Review – Triage tools for detecting cervical spine injury in paediatric trauma patients

Co-ordinating PI:

Emma Tavender

Study Co-ordinator: N/A
Project aim/s:

To expand the scope and update the Cochrane review ‘ Triage tools for detecting cervical spine injury in paediatric trauma patients (updated search from 2017 to 3 June 2021) to determine the diagnostic accuracy of clinical decision rules (CDRs) or sets of clinical criteria used to evaluate for cervical spine injury (CSI) following blunt trauma in a paediatric population.

Study design:

Cochrane Diagnostic Accuracy Review.

Study types:

Diagnostic studies with cross-sectional or cohort designs (retrospective or prospective) and randomised controlled trials. We only included results from full reports. We excluded case-control studies and reports that evaluated predictor finding models because of the bias they might introduce. We preferred studies that evaluated the accuracy of CDRs in direct comparisons to each other, however, we did not exclude studies with indirect comparisons as we expected the number of studies with direct comparisons to be limited.

Index test:

Any CDR or set of clinical criteria that compared the diagnostic accuracy of the test for the target condition with the reference standard.

Reference test:

Computed tomography (CT), plain radiography (X-ray) or magnetic resonance imaging (MRI). We also included studies where the cervical spine was clinically cleared in the emergency department in low risk patients at the treating clinician’s discretion. We preferred to include studies where patients who did not receive imaging underwent either a medical record review or an additional follow up some time after discharge to ensure no CSIs were missed or other systems were used to ensure initially missed CSI were diagnosed. The imaging or clinical follow up should be undertaken within 72 hours of presentation to the ED.

Target condition:

Clinically-important cervical spine injury (CSI), defined as any fracture, dislocation, ligamentous injury or spinal cord injury (either detectable by diagnostic imaging or spinal cord injury without radiographic association) involving the cervical region and attaching ligamentous structures.

Current status:

Completed, accepted and currently being copy-edited.

 

 

 

PREDICT Members Meeting – 15th November 2023 – REGISTRATIONS CLOSING NOVEMBER 2ND

Registration closes on November 2nd for the PREDICT members meeting.  This is a hybrid event so both face to face and virtual attendance is offered, however we are hoping for as many members as possible to attend in person. Registration via Trybooking is required for both modes of attendance.   See AGENDA here.  Please note:  The dinner is scheduled for the NIGHT PRIOR to the members meeting.

PLEASE NOTE:  Registration closes on THURSDAY 2/11/23 and date cannot be extended.

DATE: Wednesday 15/11/23 (one day meeting)

TIME: 9.30am – 4.30pm

VENUE: The Cox Walford Room, Level 5 West, Murdoch Children’s Research Institute, 50 Flemington Rd, Parkville, Melbourne.

REGISTRATION

  • All attendees (virtual and face to face) must register via Trybooking and be a PREDICT member. Registration closes MONDAY 2/11/23.
  • Please ensure you indicate dietary requirements during the booking process, regardless of whether or not you are attending the dinner, as catering will also be provided during the meeting.
  • If you wish to attend and are not a PREDICT member contact predict.mcri.edu.au regarding membership application prior to proceeding with Trybooking.
  • PREDICT will not sponsor attendance this year.  All accommodation and travel to be booked by the individual (excluding PREDICT executive members who will be attending the PREDICT executive meeting the day before).
  • Suggested accommodation close to RCH/MCRI
    The Larwill Art Series Hotel
    Mercure North Melbourne

    Dinner  (NIGHT PRIOR TO MEMBERS MEETING)
  • The PREDICT dinner will be held on 14/11/2023 (night prior) from 6.30pm – 9.00pm at the Leveson Hotel, 46 Leveson St, North Melbourne which is a short walk from the Larwill Hotel/MCRI.
  • The dinner includes a 3 course menu with a range of meat, seafood and vegetarian options.  Drinks are available at bar prices.
  • Payment of $60 (plus 50 cent booking fee) must be made via Trybooking during the registration process.  Choose “In person + dinner option”.
  • Booking and payment must be received by THURSDAY 2/11/23.

QUESTIONS?

Please contact predict.mcri.edu.au.

Getting to know you – meet Katherine Cantos

Our “Getting to Know You” segment ensures PREDICT members are aware of new members, their interests and areas of expertise and where they are located.

This month we introduce Katherine Cantos from Monash Children’s Hospital.

“I work at Monash Children’s Hospital in Emergency, the Canopy ward and now with the paediatric ED research team! I’m very interested in research as I’d love to be a part of learning about and making improvements to the care we provide in hospital so that we can improve oucomes for unwell children all over the world. Every little bit counts and I’ve very much enjoyed getting on board with the research team to work with other nurses and doctors in our Emergency Department in a variety of different and interesting projects.”

Welcome to PREDICT Katherine!

 

 

 

 

 

New PREDICT publications

Congratulations to the following PREDICT authors:

Curran J, Wozney L, Tavender E, Wilson C, Ritchie KC, Wong H, Gallant A, Somerville M, Archambault PM, Cassidy C, Jabbour M, Mackay R, Plint AC “Implementing Electronic Discharge Communication Tools in Pediatric Emergency Departments: Multicountry, Cross-Sectional Readiness Survey of Nurses and Physicians”. JMIR Hum Factors 2023;10:e46379 doi: 10.2196/46379  PMID: 37819696.

Parr M, Wilson CL, Jones B, Crawford NW, Ferguson S, Ramesh S, Eapen N, Craig S, Hearps S, Babl FE. Emergency department presentations for chest complaints after mRNA COVID‐19 vaccinations in children and adolescents. Emergency Medicine Australasia. 2023-10-23. DOI: 10.1111/1742-6723.14327.

Getting to know you – meet Louise Mills

Our “Getting to Know You” segment ensures PREDICT members are aware of new members, their interests and areas of expertise and where they are located.

This month we introduce Louise Mills from Prince Charles Hospital, Brisbane.

“I work at The Prince Charles Hospital, Brisbane where we have separate General Adult and Children’s emergency departments. I work as both a Clinical Nurse in General ED and as a Nurse Researcher within both Emergency Departments. In my role as part of the research team I am responsible for recruitment and clinical data collection of studies currently underway and I also prepare information for the Site Specific Applications for future studies. I feel privileged to be actively involved in both locally and internationally recognised research, and to be able to contribute to the health and wellbeing of people of all ages and their families.”

Welcome to PREDICT Louise!

 

 

 

 

 

Project Snapshot – Head Injury Co-design

Co-designing discharge communication strategies for paediatric minor head injuries.

Co-ordinating PI:

Emma Tavender/Franz Babl

Study Co-ordinator ANZ

Emma Tavender/Cate Wilson

Study aim/s:

To improve discharge communication currently provided to children presenting to the ED with mild to moderate head injuries (concussion). Specifically, adolescents who have an increased risk of post-concussion symptoms (PCS).

Study design:

Mixed Methods:  stepped co-design method to engage consumers (parents and youths) and clinicians in the development of head injury discharge communication strategies.

Primary outcome:

Co-designed discharge communication strategies for adolescents with mild to moderate head injuries (concussion) with parents, youths and clinicians.

Additional outcomes:
  • Training materials that can be used for future co-design efforts
  • Advancement in the science of implementation and contribution to future discharge communication strategy development for other common paediatric ED presentations.
Current status:
  • Ethics received from RCH and Western Health.
  • Recruited four parents, four clinicians and three youths to participate.
  • Orientation/training session plus three meetings held.
  • Priorities for improvement have been determined.
  • List of priorities reduced to two key areas for improvement: Head injury: what to expect in the ED and Concussion discharge information.
  • Prototype to address the two key priorities that have been developed and updated in response to new International Sports-related Concussion guidance (Amsterdam 2023)
  • Plan to start usability testing end 2023/early 2024.

 

 

 

BREAKING NEWS – NHMRC Centre of Research Excellence grant application successful!

We are very excited to announce that we have received NHMRC (National Health and Medical Research Council) CRE funding ($2.5m) for the next 5 years which will support us to continue our PREDICT research plans.

The new CRE will continue to target conditions including sepsis and acute respiratory conditions like asthma, bronchiolitis and pneumonia. Additionally there will be a focus on improving family input at all stages of the trial design and execution and improved translation plus tracking of changes in care.

Over the next five years, the grant will also fund the creation of a family-facing smartphone app for families for certain high-risk conditions and an emergency department-focused implementation toolkit that can be adapted for hospitals across Australia and New Zealand.

The NHMRC funding will also develop Australia’s future workforce, training emerging leaders in emergency care through the creation of higher degree scholarships and postdoctoral opportunities. Through research and the implementation of best evidence, students and researchers within the CRE in Paediatric Emergency Medicine will be mentored across specialties and disciplines to become independent researchers who can improve the lives of all children who visit emergency departments.

The application was a massive collaborative effort from many people across many sites and thanks goes to all involved in this successful application.

We will discuss the CRE at the next PREDICT members meeting in November and look forward to an exciting and productive future for PREDICT!

Getting to know you – meet Lara Caruso

Our “Getting to Know You” segment ensures PREDICT members are aware of new members, their interests and areas of expertise and where they are located.

This month we introduce Lara Caruso.

“I work in the Paediatric Emergency Department at the Womens & Childrens Hospital, Adelaide both on the floor as a Clinical Nurse and under Dr Amit Kochar as a Research assistant. Although I have a general interest in all paediatric emergency research, mental health would be my favourite.”

Welcome to PREDICT Lara!

 

 

 

 

 

RA study day in Melbourne – very successful meeting!

Our presenters did a great job of keeping the crowd entertained!

Interactive and entertaining CHOICE UTI presentation from Laila.

Drinks and dinner at Captain Melville.

Our Perth team enjoy the group dinner.

 

Fifty-three clinical research staff from 23 sites across Australia, attended training for the CHOICE UTI, Mental Health Observational, FEBCON, SPASMS and Asthma prospective studies.  This event was held at the Murdoch Children’s Research Institute in Melbourne on 24th and 25th July 2023.

This meeting provided an opportunity to meet fellow colleagues in the research team and learn about how these new studies will run in view of different settings.
There is nothing quite like being able to ask questions and give answers in a face to face context!

Thanks to the organising team including: Marian Chandler, Cate Wilson, Simon Craig, Naomi Loftus and Marietta John-White for ensuring the smooth running of this successful event.